氨甲环酸治疗老年股骨转子间骨折PFNA术后隐性失血疗效及安全性分析.docVIP

氨甲环酸治疗老年股骨转子间骨折PFNA术后隐性失血疗效及安全性分析 　　[摘要]目的 ?^察评价氨甲环酸（TXA）治疗老年股骨转子间骨折（ITF）行股骨近端螺旋刀片抗旋髓内钉（PFNA）术后隐性失血（IBL）的临床效果与安全性。方法 选择2014年3月～2016年4月期间东莞市第五人民医院骨科收治老年股骨转子间骨折（ITF）患者66例，所有的患者手术均由同一组经验丰富主治医师以上完成，均采取PFNA治疗，将所有患者随机对照试验（RCT）分为两组，观察组33例给予氨甲环酸治疗；对照组33例常规生理盐水治疗，并比较两组的临床效果。结果 观察组手术时间、显性失血量与对照组比较均无统计学意义（t=-0.0485、1.2416，P0.05），观察组术前及术后隐性失血量均明显的少于对照组（t= -12.8791、-11.1124，P0.05），观察组术后3、7d外周血Hb水平均显著的高于对照组（t=3.6674、3.8903，P0.05）。结论 氨甲环酸治疗老年股骨转子间骨折PFNA较好地控制术后隐性失血，安全性较好，能显著降低血栓的发生率，值得基层医院临床大力推广使用。 　　[关键词] 老年患者；股骨转子间骨折；股骨近端防旋髓内钉；隐性失血 　　[中图分类号] R683.4 [文献标识码] A [文章编号] 2095-0616（2017）11-29-04 　　Analysis on efficacy andsafety of tranexamic acid in treatment of invisible blood loss after PFNA in elderly patients withintertrochanteric fracture 　　LI Yuqiang1 SU Songsen1 HUANG Jianjun1 LIU Yongqing1 YU Haibin1 　　WU Tanghong2 　　1.Department of Orthopedics， the Fifth Peoples Hospital of Dongguan City， Dongguan 523900， China； 2.Department of Anesthesiology， the Fifth Peoples Hospital of Dongguan City， Dongguan 523900， China 　　[Abstract] Objective To observe and evaluate the clinical effect and safety of tranexamic acid （TXA） in treatment of invisible blood loss （IBL） after proximal femoral nail anti-rotation （PFNA） in elderly patients with intertrochanteric fracture （ITF）. Methods 66 elderly patients with intertrochanteric fracture （ITF） who were admitted to Department of Orthopedics in The Fifth People’s Hospital of Dongguan from March 2014 to April 2016 were selected. All patients underwent surgery performed by experienced physicians whose clinical level above that of attending physicians in the same group and they were all received PFNA treatment. All patient were divided into two groups according to Randomized Controlled Trial （RCT）， 33 patients in the observation group were given tranexamic acid for treatment while 33 patients in the control group were given routine normal saline. Clinical effects of two groups were compared. Results There was no significant difference in opera